Written by Chrystal Moulton, Staff Writer. Supplementation with alpha lipoic acid saw significant reduction in symptoms of neuropathic pain observed in patients with diabetes mellitus (P <0.001).
Alpha lipoic acid is an antioxidant that supports energy production in mitochondria. In both extracellular an intracellular space is Alpha lipoic acid efficiently defused, is well absorbed, and is able to penetrate the blood brain barrier 1. Studies on diabetic neuropathy have shown that Alpha lipoic acid improves blood flow in the nerves, distal nerve conduction, and reduces oxidative stress 2. Worldwide, approximately 9% of adults are affected by diabetes. Among patients with diabetes, neuropathy occurs at a rate between 5.3 to 47.6% 3,4. The exact pathogenesis of diabetic neuropathy is unknown, however, it is thought that metabolic and vascular defects increased by oxidative stress may play a significant part in the development of diabetic neuropathy 5. Researchers in the current study prospectively investigated the effect of 600 mg per day of Alpha lipoic acid on overall health status, quality of life, and symptoms of painful diabetic neuropathy in patients with type 1 or type 2 diabetes mellitus 6.
In this prospective interventional trial, 72 patients (18- 75 years old) with type one or type 2 diabetes mellitus were given 600 milligrams of Alpha lipoic acid daily for 40 days. Patients continued taking their prescribed medicines during the trial. Diabetic neuropathy was assessed through questionnaires analyzing subjective scores regarding intensity and type of pain experienced, disability caused by neuropathic pain symptoms, and overall quality of life. Questionnaires were given at baseline and at the end of the trial (day 40). Laboratory assessment was done at baseline and day 40 to ensure no toxic effects of Alpha lipoic acid supplementation.
By day 40, all 72 patients completed the trial. Researchers saw statistically significant reductions in neuropathic pain symptoms as assessed through the questionnaires at baseline and at the end of the trial.
Table 1. Comparison between diabetic neuropathy scores at baseline and day 40
| Questionnaire | Baseline (mean score) | Day 40 (mean score) | P value |
|---|---|---|---|
| NSS | 7.9 | 5.3 | P < 0.001 |
| SPNS Q | 8.8 | 4.4 | P < 0.001 |
| DN 4 | 5.7 | 2.8 | P < 0.001 |
| BPI | 4.3 | 2.3 | P < 0.001 |
| NPSI | 40.1 | 20.3 | P < 0.001 |
Following 600 mg supplementations with Alpha lipoic acid, patients also noted significant reduction in spontaneous burning pain (P < 0.001), paroxysmal pain (P < 0.001), pressing deep spontaneous pain (P < 0.001), paresthesia/ dysesthesia (P < 0.001), and evoked pain (P < 0.001). 50% of participants reported feeling much better at day 40. Overall, Alpha lipoic acid was also well tolerated with no adverse effects during the length of the trial. Further investigation is needed to determine whether continued supplementation with Alpha lipoic acid will continue to reduce symptoms of painful diabetic neuropathy.
Source: Agathos, Evangelos, Anastasios Tentolouris, Ioanna Eleftheriadou, Panagiota Katsaouni, Ioannis Nemtzas, Alexandra Petrou, Christina Papanikolaou, and Nikolaos Tentolouris. “Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy.” Journal of International Medical Research 46, no. 5 (2018): 1779-1790.
© The Author(s) 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0300060518756540 journals.sagepub.com/home/imr
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Posted May 26, 2021.
Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.
Reference:
- Packer L, Witt EH, Tritschler HJ. alpha-Lipoic acid as a biological antioxidant. Free radical biology & medicine. 1995;19(2):227-250.
- Nagamatsu M, Nickander KK, Schmelzer JD, et al. Lipoic acid improves nerve blood flow, reduces oxidative stress, and improves distal nerve conduction in experimental diabetic neuropathy. Diabetes Care. 1995;18(8):1160-1167.
- International Diabetes Federation. IDF. IDF Diabetes Atlas, 9th Edition. 2019.
- Boulton AJ, Vinik AI, Arezzo JC, et al. Diabetic neuropathies: a statement by the American Diabetes Association. Diabetes Care. 2005;28(4):956-962.
- Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615-1625.
- Agathos E, Tentolouris A, Eleftheriadou I, et al. Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy. The Journal of international medical research. 2018;46(5):1779-1790.
